Epidemiology of ectopic pregnancy at Laquintinie Douala hospital (Cameroon): prevalence survey, clinical profile, therapeutic and transfusion issues

Background: Pregnancy is a serious pathology of the first trimester of pregnancy and is the leading cause of death. The objective of our work was to determine the hospital prevalence of ectopic pregnancy (EP), to describe the epidemiological, clinical and therapeutic profile given the often-haemorrhagic context at Laquintinie Hospital in Douala.Methods: We carried out a retrospective study over 10 years, from January 1st, 2007 to December 31st, 2016, using the operating theatre registers and the files of patients admitted during this period for ectopic pregnancy in the gynaecology and obstetrics department of the Laquintinie Hospital in Douala.Results: A total of 905 cases of EP for 32,595 deliveries were recorded, for an overall incidence of 2.8%. EP mainly affected the age group of 25 to 35 (60.6%), single people (57.9%) and housewives (46.6%). The risk factors found were similar to those of cervical cancer, namely multiple sexual partners (80.4%), the precocity of sexual intercourse under 18 years (54.1%) and sexually transmitted infections (52.5%). The symptomatic triad (pelvic pain, amenorrhea and metrorrhagia) was found in 46.1% of cases with a respective order of frequency of 96.9%, 77.3% and 63.6% The management was essentially surgical by radical laparotomy (97% of cases). Two of the 07 deaths were due to religious considerations.Conclusions: EP remains a frequent pathology in our environment with a heavy toll of tubal amputations and death

Benefits of sexual practice during pregnancy: myth or reality? Comparative study and outcome of childbirth in Douala (Cameroon)

Background: Pregnancy is the term used to describe the period in which a foetus develops in the uterus and lasts 40 weeks measured from the last menstrual period. Anatomic and physiologic changes in pregnant women usually make couples to change their emotional and sexual activities that may impact childbirth. There are few studies in our setting that describe the roles of sexual practice during pregnancy and maternal-foetal outcomes of childbirth.Objective of this study aimed at assessing the benefits of sexual practice during pregnancy in a target population and to assess the outcome.Methods: We carried out a comparative cross-sectional study from February 2018 to May 2018, at the maternity of Laquintinie Hospital in Douala. Socio-demographic, obstetric, sexual history in pregnancy, birth and neonatal data were collected using a structured questionnaire. Univariate and multivariate analyses were conducted at a 95% confidence interval.Results: A total of 300 respondents completed study and 69.6% were favourable to sexual intercourse during pregnancy. Induction or augmentation of labour was common in the unfavourable group [OR: 2.52 (1.53-4.15); p=0.004]. Almost one in two participants gave birth by caesarean section and the indications for caesarean section were similar in both groups. Participants without sexual intercourse in pregnancy had a 9-fold increased risk of perineal tears [OR: 8.99 (4.02-10.1); p=0.001] and 5.4-fold risk of cervical tears [OR: 5.44 (2.44-8.73); p=0.0001].Conclusions: Sexual practice in pregnancy appears to be protective against excessive use of oxytocin, perineal and cervical tears

Evaluation of quality of life and associated factors among HIV patients on antiretroviral therapy in North West region of Cameroon

Background: There is evidence that Quality of Life (QoL) of People Living with HIV/AIDS (PLHIV) has a significant role in ART retention, treatment adherence, and survival. As a result, QoL is becoming increasingly important for policymakers, program implementers, and researchers. However, factors associated with QoL, in a culturally diverse country like Cameroon are unknown. Objective: We aimed to assess the QoL of PLHIV on ART and assess the extent to which physical, psychosocial, environmental, and spiritual factors drive QoL. Method: A cross-sectional study was conducted among 394 PLHIV aged >21 in North-West Cameroon from April to July 2019. Data were collected using WHO-QOL BREF questionnaire. Descriptive statistics, bivariate, and multivariate linear regression analyses were performed. Results: Majority (34.5%) of participants were in the age range of 41-50, with 73% females. The average QoL of the respondents was \u201cgood\u201d with mean score of 3.57 on 5 and 71.4% agreed to have satisfactory QoL. Bivariate regression analyses revealed that all six proposed predictors were significantly associated with QoL. Psychological factors made the greatest impact (\u3b2 = 0.213; p<0.003), followed by physical factors (\u3b2 = 0.19; p<0.001). Conclusion: PLHIV fairly agreed to have good QoL. The QoL was driven by mainly psychological and physical factors and not level of independence. However, the mean score perceptions for the investigated domains were low. Mental health services should consider these predictors when designing strategies to improve the QoL of PLHIV. While this study provides useful insights, other possible drivers of QoL among PLHIV should be investigated

Predictors of antiretroviral therapy interruptions and factors influencing return to care at the Nkolndongo Health District, Cameroon

Background: Antiretroviral therapy is a lifelong commitment that requires consistent intake of tablets to optimize health outcomes, attain and maintain viral suppression. Objective: We aimed to elicit predictors of treatment interruption amongst PLHIV and identify motivating factors influencing return to care. Method: We conducted a cross-sectional study using a mixed-method approach in four hospitals in Yaound\ue9. Sociodemographic and clinical data were collected from ART registers. Using purposeful sampling, thirteen participants were enrolled for interviews. Quantitative data were analyzed using Epi-Info and Atlas-TI for qualitative analysis. Ethical clearance approved by CBCHS-IRB. Results: A total of 271 participants records were assessed. The mean age was 33 years (SD\ub111years). Private facilities CASS and CMNB registered respectively 53 (19.6%) and 14 (5.2%) participants while CMA Nkomo and IPC had 114 (42.1%) and 90 (33.2%) participants. Most participants (75.3%) were females [OR 1.14; CI 0.78-1.66] compare with males. 78% had no viral load test results. Transport cost and stigmatization constituted the most prominent predictors of treatment interruption (47.5%) and (10.5%) respectively. Belief in the discovery of an eminent HIV cure and the desire to raise offspring motivated 30% and 61%, respectively to resume treatment. Conclusion: Structural barriers like exposed health facility, and dispensing ARVs in open spaces stigmatizes clients and increases odds of attrition. Attrition of patients on ART will be minimized through implementation of client centered approaches like multiplying proxy ART pick points, devolving stable clients to community ARV model

Hepatitis B, HIV, and Syphilis Seroprevalence in Pregnant Women and Blood Donors in Cameroon

Objectives. We estimated seroprevalence and correlates of selected infections in pregnant women and blood donors in a resourcelimited setting. Methods. We performed a cross-sectional analysis of laboratory seroprevalence data from pregnant women and voluntary blood donors from facilities in Cameroon in 2014. Rapid tests were performed to detect hepatitis B surface antigen, syphilis treponemal antibodies, and HIV-1/2 antibodies. Blood donations were also tested for hepatitis C and malaria. Results. The seroprevalence rates and ranges among 7069 pregnant women were hepatitis B 4.4% (1.1-9.6%), HIV 6% (3.0-10.2%), and syphilis 1.7% (1.3-3.8%) with significant variability among the sites. Correlates of infection in pregnancy in adjusted regression models included urban residence for hepatitis B (aOR 2.9, CI 1.6-5.4) and HIV (aOR 3.5, CI 1.9-6.7). Blood donor seroprevalence rates and ranges were hepatitis B 6.8% (5.0-8.8%), HIV 2.2% (1.4-2.8%), syphilis 4% (3.3-4.5%), malaria 1.9%, and hepatitis C 1.7% (0.5-2.5%). Conclusions. Hepatitis B, HIV, and syphilis infections are common among pregnant women and blood donors in Cameroon with higher rates in urban areas. Future interventions to reduce vertical transmission should include universal screening for these infections early in pregnancy and provision of effective prevention tools including the birth dose of univalent hepatitis B vaccine

Supplement use during an intergroup clinical trial for breast cancer (S0221)

The use of supplements during chemotherapy is controversial, partly due to the potential effect of antioxidants on reduced efficacy of chemotherapy-related cytotoxicity. We examined supplement use among breast cancer patients registered to a clinical trial (SWOG 0221) before diagnosis and during treatment. Patients (n = 1,467) completed questionnaires regarding multivitamin and supplement use at trial registration (baseline) to capture use before diagnosis. Of these patients, 1,249 completed a 6-month followup questionnaire to capture use during treatment. We examined the use of vitamins C, D, E, B6, B12, folic acid, and calcium at these timepoints, as well as physician recommendations regarding supplement use. The use of vitamins C, E, folic acid, and calcium decreased during treatment, while the use of vitamin B6 increased. Five hundred seventy four patients (51 %) received no physician recommendations regarding supplement use. Among the remaining 49, 10 % were advised not to take multivitamins and/or supplements, 7 % were advised to use only multivitamins, and 32 % received recommendations to use multivitamins and/or supplements. Among patients who took vitamin C before diagnosis, those who were advised not to take supplements were >5 times more likely not to use of vitamin C during treatment than those not advised to stop use (OR = 5.27, 95 % CI 1.13–24.6). Previous non-users who were advised to take a multivitamin were nearly 5 times more likely to use multivitamins during treatment compared to those who received no recommendation (OR = 4.66, 95 % CI 2.10–10.3). In this clinical trial for high-risk breast cancer, supplement use generally decreased during treatment. Upon followup from the clinical trial, findings regarding supplement use and survival outcomes will better inform physician recommendations for patients on adjuvant chemotherapy

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Risk factors for acute respiratory infections in children under five years attending the Bamenda Regional Hospital in Cameroon

Abstract Background Acute respiratory infections (ARI) are a leading cause of morbidity and mortality in under-five children worldwide. About 6.6 million children less than 5 years of age die every year in the world; 95% of them in low-income countries and one third of the total deaths is due to ARI. This study aimed at determining the proportion of acute respiratory infections and the associated risk factors in children under 5 years visiting the Bamenda Regional Hospital in Cameroon. Methods A cross-sectional analytic study involving 512 children under 5 years was carried out from December 2014 to February 2015. Participants were enrolled by a consecutive convenient sampling method. A structured questionnaire was used to collect clinical, socio-demographic and environmental data. Diagnosis of ARI was based on the revised WHO guidelines for diagnosing and management of childhood pneumonia. The data was analyzed using the statistical software EpiInfo™ version 7. Results The proportion of ARIs was 54.7% (280/512), while that of pneumonia was 22.3% (112/512). Risk factors associated with ARI were: HIV infection ORadj 2.76[1.05–7.25], poor maternal education (None or primary only) ORadj 2.80 [1.85–4.35], exposure to wood smoke ORadj 1.85 [1.22–2.78], passive smoking ORadj 3.58 [1.45–8.84] and contact with someone who has cough ORadj 3.37 [2.21–5.14]. Age, gender, immunization status, breastfeeding, nutritional status, fathers’ education, parents’ age, school attendance and overcrowding were not significantly associated with ARI. Conclusion The proportion of ARI is high and is associated with HIV infection, poor maternal education, exposure to wood smoke, passive cigarette smoking, and contact with persons having a cough. Control programs should focus on diagnosis, treatment and prevention of ARIs